静脉注射利多卡因并不会减少腹式子宫切除术后的住院时间。

Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy.

机构信息

Department of Anesthesiology, The Ottawa Hospital - Civic Campus, Ottawa, ON, Canada.

出版信息

Can J Anaesth. 2010 Aug;57(8):759-66. doi: 10.1007/s12630-010-9332-2. Epub 2010 Jun 8.

DOI:10.1007/s12630-010-9332-2

PMID:20532723

Abstract

PURPOSE

Intravenous lidocaine given both intraoperatively and postoperatively decreases pain scores, reduces opioid consumption, and promotes faster return of bowel function following abdominal surgery. The purpose of this trial was to determine if intravenous lidocaine limited to the intraoperative period reduces length of hospital stay and improves functional recovery following abdominal hysterectomy.

METHODS

Following Research Ethics Board approval and informed consent, women of American Society of Anesthesiologists' class I and II undergoing abdominal hysterectomy were assigned randomly to lidocaine and control groups. Lidocaine subjects received an intravenous bolus of 1.5 mg.kg(-1) followed by an infusion of 3 mg.kg(-1).hr(-1), while control subjects received matching placebo. Patients, anesthesiologists, and study personnel were blinded, and anesthesia and multimodal perioperative analgesia were standardized. The primary outcome of this trial was discharge from hospital on or before the second postoperative day (POD2). Additional criteria were assessed for secondary outcomes, i.e., discharge fitness on POD2, length of hospital stay, opioid use, numeric rating scores for pain, quality of recovery, and recovery of bowel function.

RESULTS

Ninety of the 93 women who were recruited completed the study protocol. The characteristics of the patients in both groups were similar-lidocaine group (n = 44) and control group (n = 46)-and no difference was noted between groups in the numbers of women discharged from hospital on POD2 (10 lidocaine, 15 control; P = 0.295). Days to discharge fitness (P = 0.666) and length of hospital stay (P = 0.456) were also similar. Differences in opioid consumption, pain scores, and recovery were neither clinically nor statistically significant.

CONCLUSION

Intraoperative administration of intravenous lidocaine did not reduce hospital stay or improve objective measures of analgesia and recovery following abdominal hysterectomy. This trial was registered at ClinicalTrials.gov (NCT00382499).

摘要

目的

静脉给予利多卡因无论是在手术期间还是手术后，都可以降低疼痛评分，减少阿片类药物的消耗，并促进腹部手术后更快地恢复肠道功能。本试验的目的是确定在手术期间仅给予静脉利多卡因是否可以减少住院时间并改善腹部子宫切除术后的功能恢复。

方法

经伦理委员会批准并获得知情同意后，接受腹部子宫切除术的美国麻醉医师协会（ASA）I 级和 II 级的女性患者被随机分配到利多卡因组和对照组。利多卡因组患者给予 1.5mg/kg 的静脉推注，然后以 3mg/kg/hr 的速度输注，而对照组患者给予匹配的安慰剂。患者、麻醉师和研究人员均处于盲态，麻醉和多模式围手术期镇痛标准化。本试验的主要结局是在术后第 2 天（POD2）或之前出院。还评估了次要结局的其他标准，即 POD2 时出院适应性、住院时间、阿片类药物使用、疼痛数字评分、恢复质量和肠道功能恢复。

结果

93 名招募的女性中有 90 名完成了研究方案。两组患者的特征相似-利多卡因组（n=44）和对照组（n=46）-且在 POD2 出院的女性人数方面，两组之间没有差异（10 例利多卡因，15 例对照组；P=0.295）。出院适应性（P=0.666）和住院时间（P=0.456）也相似。阿片类药物消耗、疼痛评分和恢复的差异在临床和统计学上均无显著性。